What is the prevalence of pediatric pneumococcal infections in the US?

Updated: Jan 14, 2019
  • Author: Meera Varman, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Invasive disease is most frequent in children younger than 2 years and in adults older than 65 years. Overall annual incidence of invasive disease in the United States is 15 cases per 100,000 individuals but widely varies by age, from 166 cases per 100,000 children younger than 2 years to 5 cases per 100,000 young adults. After the introduction of heptavalent conjugated pneumococcal vaccine, the rate of invasive pneumococcal disease (IPD) has trended down. [2, 3] In an active laboratory surveillance from 1997-2004, the IPD decreased by 40% from 11.8 cases to 7.2 cases per 100,000 live births. Among black infants, a marked decrease was noted in incidence of IPD from 17.1 cases to 5.3 cases per 100,000 live births compared with white infants with a decrease from 9.6 cases to 6.8 cases per 100,000 live births.

From 1999-2007, a 92% reduction in vaccine serotypes has been observed among both invasive and noninvasive isolates; during the same period, a 200% increase has been observed in vaccine-related or nonvaccine serotypes. Among these, serotypes 19A, 6C, 15, and 22F were predominantly noted. [4] The amoxicillin susceptibility was about 70% compared with 50% in macrolides. Serotype 6C is considered to be emerging as well. [5]

An increased frequency of disease and increased morbidity and mortality rates are seen in children younger than 2 years and in children with humoral immunodeficiency (eg, HIV infection, agammaglobulinemia, complement deficiency), absent or deficient splenic function (eg, splenectomy, sickle cell anemia), nephrotic syndrome, chronic renal failure, organ transplantation, immunosuppressive therapy, chronic pulmonary disease, cerebral spinal fluid (CSF) leak after skull fracture, cochlear implant, diabetes mellitus, and malignancy. Parental smoking invariably increases acute otitis media by about 64% compared to no history of parental smoking (56%).


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